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Muscle weakness, which is common in MS, can occur in any part of the body. The first step in managing weakness effectively is to determine what is causing it.

Deconditioning of muscles results from lack of use. Often in MS, due to fatigue, pain, imbalance, or other symptoms, a person’s overall activity level is reduced. Lack of activity will cause the muscles affected by MS, as well as those that are not affected by the disease, to become weak. For this type of weakness, progressive resistive exercise with weights can be very effective. A physical therapist can recommend a weight-training program that fits with your abilities and limitations.

Damage to the nerve fibers (demyelination) in the spinal cord and brain that stimulate the muscles can also cause weakness. The muscles are not receiving the nerve impulses they require in order to work effectively – which often results in t a reduction in endurance. Because the source of this type of weakness is impaired nerve conduction, weight training to strengthen the affected muscles is not effective – and may even increase feelings of weakness and fatigue. The recommended strategy is to maintain the tone of those muscles that are not receiving adequate nerve conduction with regular use, while working to strengthen the surrounding muscles that are receiving adequate conduction. A physical therapist can work with you to identify the sources of your weakness and recommend appropriate strategies to manage them.

Weakness in the legs, ankles and feet can interfere with walking. Management strategies to address walking problems include exercise, assistive devices and medication. Weakness in the upper body and arms can interfere with activities of daily living and self-care. Occupational therapists can recommend appropriate exercises for your arms and hands, as well as tools and devices to assist with activities in the home and at work.